Needle Fasciectomy Case Study

A recent study conducted that compared the cost-effectiveness of fasciectomy, aponeurotomy and CCH from a societal perspective, concluded that aponeurotomy was the preferred strategy for managing contractures affecting a single finger16. In our study, we didn't compare needle fasciectomy for several reasons. First, it is not usually used in our hospital. Second, even though needle fasciectomy is by far the cheapest treatment, recurrence rates vary after 5 years from 50-85%24. Education and physiotherapy costs have to be added to the advantages of a minimally aggressive procedure. In one analysis which was conducted, an additional review of the recurrence rate according to the technique used for the treatment of DC, concluded that needle fasciotomy had a recurrence rate of 60%, fasciectomies 30% and CCH infiltration only 15%

These utilities have been obtained by a survey which included 13 standard gamble scenarios based on the decision tree. Utilities for interventions for DC were of high universality, but it is possible that it does not reflect exactly the preferences of our patients. They did not report all possible outcomes or health states for each therapeutic alternative, so we had to deduct from the utilities reported in the others. In contrast to the other studies on the failure scenarios for each intervention16, we subtracted the complications referred as disutilities. Therefore, we performed a scenario sensibility analysis to check if our model could change in comparison to a standard model, providing a similar ICUR and contributing to our findings’ robustness. A more accurate and realistic approach would be to use utilities depending on the dominant hand, finger, joints and degrees of DC severity28. Also, these utilities could be reflected better in our patients’ preferences because Glasgow (Scotland) has a similar European Health